During surgery procedures, especially in spine procedures, medical staff is required to determine the position orientation and the path of medical devices (e.g., pedicle screws, rods, joints & other implants) and surgical tools (e.g., screwdriver, drill, surgical knife) to avoid damage to the spinal cord, aorta or other relevant organs. Furthermore, the physician may be required to determine additional medical information such as the dimensions of a resected disc (i.e., to determine if the entire disc was resected) or the dimensions of a cavity size (e.g., to determined the size of an implant). During these surgery procedures, the medical staff acquires the position orientation and the path of medical devices or that additional medical information utilizing a fluoroscopic imaging system to image the anatomy and the medical devices in the surgical area. Thus, the medical staff, and the patient are exposed to radiation doses due to the use of the fluoroscopic imaging system.
U.S. Pat. No. 6,741,883 issued to Gildenberg et al, and entitled “Audible Feedback from Positional Guidance Systems”, is directed to a system for generating audible feedback to assist with the precise insertion of a pedicle screw. The feedback generating system includes a computer system, one visualizing video camera, two localizing video cameras, eight fiducial markers, a medical probe and a loudspeaker. The computer system includes a processor and a monitor. The computer is coupled with all the cameras and with the loudspeaker. The computer stores a reconstructed three-dimensional (3D) volumetric image of the relevant part of the body of the patient. Four fiducial markers are mounted on the body of the patient in the proximity to the surgical region (e.g., in brain surgery the fiducial markers are on the top of the head, the back head, the temporal area and the nose bridge). Four more fiducial markers are mounted on the medical probe allowing the tracking of the position and orientation of the medical probe.
The 3D volumetric image is reconstructed before the surgery from volumetric images taken by computerized tomography scan or magnetic resonance imaging scan. The three cameras acquire images of the medical probe and the surgical field, and send the image data to the computer. The computer generates a three dimensional image from the image data obtained by the cameras. The computer superimposes a representation of the location and position of the probe, obtained by the camera images, on the 3D image generated by the computer. The computer coordinates and matches the superimposed three dimensional image with the three dimensional volumetric image, using the fiducial markers on the patient and on the medical probe. The monitor displays the combined image. The computer sends the loudspeaker signals corresponding to the location of the probe relative to the body of the patient. The loudspeaker generates an audio signal to augment the visual display on the monitor to help a surgeon in navigating the probe.
U.S. Pat. No. 6,856,827 issued to Seeley et al., and entitled “Fluoroscopic Tracking and Visualization System”, is directed to a system for surgical imaging. The visualization system includes a fluoroscope, a processor, a display and a plurality of tracking elements. The processor is coupled with the fluoroscope and with the display. The first tracking element is mounted on the medical probe. The second tracking element is mounted on the fluoroscope. The third tracking element is mounted on the body of a patient. Thus so the fluoroscope, the patient and the probe are dynamically referenced.
The fluoroscope acquires images of the body of the patient from several angles. The processor constructs a three dimensional image of the body of the patient, that is dynamically referenced to the medical probe and the patient, from the fluoroscope images. The processor fuses the three dimensional image with a preoperative volumetric data for simultaneous display of both sets of images. The preoperative volumetric data is a volumetric data acquired prior to the medical procedure by a volumetric imager (e.g., CT, PET or MRI).
U.S. Pat. No. 6,782,287 B2 issued to Grzeszczuk et al. and entitled “Method and Apparatus for Tracking a Medical Instrument Based on Image Registration” is directed to a method, a system and apparatus for tracking a surgical instrument with respect to the patient's anatomy and pre-operative diagnostic scans, using intra-operative fluoroscopy and to provide stereoscopic registration in order to relate the patient's anatomy to the pre-operative diagnostic scans in 3-D. The system includes a fluoroscopic device, a surgical instrument, a position sensor and a computer system. The fluoroscopic device includes an X-ray camera and an image intensifier. The surgical instrument and image intensifier each include emitters, (such as LEDs). The position sensor is coupled to the computer system, and the computer system is coupled to the X-ray camera.
The position sensor tracks the position of the emitters, and supplies the computer system with data required to perform transformations between various coordinate systems. The images acquired by the X-ray camera are also supplied to the computer system for processing. These images are used to register a pre-operative CT data set to the patient's reference frame. These images then are used to compute the C-Arm-to-CT data set registration. The tracking of the surgical tool involves the back-projection of the surgical tool onto the reference frame of the CT data set using stereoscopic techniques, by utilizing at least two fluoroscopic views of the surgical tool. Using this composite rendition, the surgical tool is then tracked with respect to a 3-D model of the anatomical structure of interest.
U.S. Pat. No. 6,640,127 to Kosaka et al, entitled “Surgical Operation Navigating System Using a Reference Frame”, directs to a surgical operation navigating system using such a reference frame. The system includes a reference frame fitted with fiducial markers, an imaging unit (e.g., CT or MRI), a surgical instrument of an observation unit for observing the site of operation, a position sensor for detecting the attitude of the surgical instrument or the observation unit and a display, all coupled with a computer. The computer registers the coordinate systems of the position sensor, the surgical instrument of an observation unit and the images acquired by the imaging unit. The display displays navigation related information and image information provided by the computer.